ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

In two decades there has been a sweeping metamorphosis of the antiquated conception of breast cancer as a solitary mass of questionable operability, accompanied by numerous axillary lymph nodes and probably distant metastasis. An undreamed-of recognizable preclinical stage of breast cancer has drastically changed attitudes and reactions in physicians and patients. These changes have paralleled the applications of clinical mammography. The smallest of premammography breast cancers are now advanced cancers. The average size of operable breast cancers at Emory University is now less than 1 cm in diameter, and ten-year cure rates with minimal cancers exceed 95%. The treatment of these minimal breast cancers, often in a two-stage surgical procedure with the patient participating in decisions, may include psychotherapy and reconstructive surgery. Pathologists have assumed new roles in coping with disturbing epithelial cellular changes in premalignant and borderline malignant breast lesions. Today predictive clinical signs and symptoms are associated with advanced cancer, with limited specific clinical changes relating to early breast cancer. Over one third of breast cancers are being discovered in women under 50 years of age, and mammography is the primary means of detecting these cancers.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The experience of the Southern Regional Trophoblastic Disease Center includes 222 patients who were referred from January 1972 to October 1977. The initial tissue diagnosis was hydatidiform mole in 212 patients and choriocarcinoma in ten. There was spontaneous remission of 142 (69%) of the moles and one of the choriocarcinomas, and 77 patients developed persistent trophoblastic disease. Of these, 58 had no evidence of metastasis, and all achieved remission with single-drug therapy. Nineteen patients developed metastases; 13 were in the “good prognosis” category, and all achieved remission with single-drug therapy. Five (83%) of the six patients with metastases in the “poor prognosis” group achieved remission with triple chemotherapy; one died of her disease.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

The occurrence of massive skin necrosis of approximately 50% of the body surface area in an 8-year-old girl with Rocky Mountain spotted fever is reported. Although the surgeon will not often be confronted with the management of Rocky Mountain spotted fever or its complications, certain therapeutic corollaries can be outlined, based upon the observed similarity between this particular complication of severe skin loss and the syndrome of purpura fulminans: (1) heparinization for the consumptive coagulopathy and disseminated intravascular clotting; (2) correction of hypovolemia and hypoproteinemia; (3) decompression by escharotomy and/or fasciotomy if indicated; (4) topical chemotherapeutic coverage of necrotic skin; (5) full-thickness eschar excision combined with biologic dressings directed toward autograft wound closure; and (6) appropriate extremity splinting and physiotherapy.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A 63-year-old man had asymptomatic Bartter's syndrome, discovered during evaluation for hypokalemia. Elevated plasma renin and aldosterone levels, angiotensin resistance, and elevated urinary prostaglandin excretion were noted. Tubular function studies implicated the proximal tubule as the site of a mild sodium reabsorption defect, and renal wasting of potassium and magnesium were also noted. Indomethacin therapy lowered the urinary prostaglandin excretion and the renin and aldosterone levels but did not correct the hypokalemia. Spironolactone therapy resulted in normalization of serum potassium but not serum magnesium levels. Bartter's syndrome may result from various causes but renal wasting of sodium, potassium and/or magnesium probably exist in all cases. Unexplained, asymptomatic hypokalemia in any age group may be due to Bartter's syndrome.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Photochemotherapy with 8-methoxypsoraleh and sunlight (PUVA-SOL), administered three times weekly, proved effective in the treatment of psoriasis. Weekend photochemotherapy (modified PUVA-SOL) also appeared useful as an adjunct to standard topical corticosteroid therapy. Careful measurement of ambient long-wave ultraviolet light (UVA) in the treatment locale and respect for the phototoxic potential of PUVA-SOL are necessary for success. The long-range toxicity of psoralen photochemotherapy remains undetermined.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A case of acute febrile neutrophilic dermatosis (Sweet's syndrome) is described in a patient with chronic myelogenous leukemia, with a review of all published reports in the English literature. The disease is characterized by an acute febrile illness with painful plaques involving the extremities, face, and neck, and responds dramatically to corticosteroids with occasional recurrences. Histologically, the skin biopsy shows a dense dermal infiltrate of polymorphonuclear leukocytes without evidence of vasculitis.

ISSN:0038-4348    

出版商:OVID    

年代:1978

数据来源: OVID